| NPI | 1104780576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-16415) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 001016415) |
| Enumeration Date | 2025-12-10 |
| Last Update Date | 2026-05-22 |