| NPI | 1932696820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2817) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA11909) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0007927) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-07-09 |