| NPI | 1932560448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT MED-Pac-LIC-91166) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-REG-0001782) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: WA PA61285554) | |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2024-05-01 |