| NPI | 1093564270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9118926) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA007715) |
| Enumeration Date | 2024-05-18 |
| Last Update Date | 2026-07-08 |