| NPI | 1780205369 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003366A) | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 085.008481) | 
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085008481) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-05 | 
| Last Update Date | 2022-12-14 |