| NPI | 1912485947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA2619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002569A) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2022-03-28 |