| NPI | 1265941710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9110725) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9110725) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2025-09-26 |