| NPI | 1972072544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 9083) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 009083) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2024-04-26 |