| NPI | 1831648443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7123) |
| 208600000X Surgery (Licence: GA 8150) | |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2023-06-15 |