| NPI | 1831840552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063513) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 60866) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA063513) | |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2023-08-29 |