| NPI | 1730658436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007047) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0007047) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2024-04-23 |