| NPI | 1912664020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8858) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 8858) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 8858) | |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2022-07-29 |