| NPI | 1629059878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO 0003579) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10000672A) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10000672A) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-02-19 |