| NPI | 1962727487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: SC TL1550) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0004149) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2023-11-27 |