| NPI | 1740945757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 112274) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2681) |
| 363AS0400X Physician Assistant, Surgical (Licence: NE 2681) | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2023-12-15 |