| NPI | 1154219871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110011281) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110011281) |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-09-15 |