| NPI | 1760986400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 0010-14801) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 8689) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 8689) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2024-11-15 |