| NPI | 1942043534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 12474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1221228) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-08-12 |