| NPI | 1861620114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA223210) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 4402) |
| 363A00000X Physician Assistant (Licence: TN 4402) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 4402) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2025-04-08 |