| NPI | 1922731900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12589) |
| 163W00000X Registered Nurse (Licence: NC 289332) | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2023-10-10 |