| NPI | 1114257342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4589) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 4589) | |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2025-08-07 |