| NPI | 1851946859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MW5542344) |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical (Licence: PA OA004865) | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2022-01-11 |