| NPI | 1598240970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060197) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA060197) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2023-02-22 |