| NPI | 1700306446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-008061) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059091) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA OA004796) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-01-12 |