| NPI | 1669191730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003989A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA3184) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-06-21 |