| NPI | 1013419464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9111072) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 13896238-1206) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2025-05-28 |