| NPI | 1619725710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: 9119521) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: FL 9119521) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-11-14 |