| NPI | 1174235725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 6925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2740) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2026-05-12 |