| NPI | 1710424593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-07057) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-07057) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2023-07-11 |