| NPI | 1871917989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 2493) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2493) |
| 363A00000X Physician Assistant (Licence: KS 1502937) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2024-08-05 |