| NPI | 1235026022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011090) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110011090) |
| 363AS0400X Physician Assistant, Surgical (Licence: NC 330722) | |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2026-03-06 |