| NPI | 1831469188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MO 2017029532) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MO 2017029532) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2024-04-25 |