| NPI | 1245876176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 2838) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 19-457) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: VA 0136001005) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC 5108) | |
| 363AS0400X Physician Assistant, Surgical (Licence: PR 2838) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238000672) | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2025-11-07 |