| NPI | 1649898602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 8136) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: AZ 8136) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2023-08-24 |