| NPI | 1952844623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC 2675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2675) |
| 363AM0700X Physician Assistant Medical (Licence: SC 2675) | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2021-08-25 |