| NPI | 1609288703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10001716A) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA1925) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2024-03-14 |