| NPI | 1922580984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 005881) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MA PA6709) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2023-10-24 |