| NPI | 1972291490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4704PA) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC MPA.4704) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: SC MPA.4704) | |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2024-10-24 |