| NPI | 1922362797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055624) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA TMA052664) |
| 363AS0400X Physician Assistant, Surgical (Licence: PA TMA052664) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2025-03-03 |