| NPI | 1952082018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023035588) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: MO 2023035588) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-11-12 |