| NPI | 1821342106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004010A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004235) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA61359713) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 029464) | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2024-02-01 |