| NPI | 1780910653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AR PA-660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2040) |
| 363AM0700X Physician Assistant, Medical (Licence: AR PA-660) | |
| 363AM0700X Physician Assistant, Medical (Licence: AK 2040) | |
| 363AS0400X Physician Assistant, Surgical (Licence: AK 2040) | |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2023-08-03 |