| NPI | 1801971106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6292) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 003116) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: DC PA30249) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-09-19 |