| NPI | 1205301322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 14052) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA199249) |
| 363AS0400X Physician Assistant, Surgical (Licence: AL PA1391) | |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2026-07-29 |