| NPI | 1902631591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 12692) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA2493) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-11-11 |