| NPI | 1093686974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 13432) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL 2691) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-10-30 |