| NPI | 1841453925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12561) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-003725) |
| 363AS0400X Physician Assistant, Surgical (Licence: SC 2107) | |
| 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005367) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2022-09-08 |