| NPI | 1275095820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9120514) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA062091) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-11-15 |