| NPI | 1134831605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NM PA2026-0079) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2023040454) |
| 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00747900) | |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2026-08-26 |