| NPI | 1164173720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5004) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 5004) |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2025-07-21 |