| NPI | 1285566703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 3180-P.A.) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 25-499) |
| 363AS0400X Physician Assistant, Surgical (Licence: PR 3180-P.A.) | |
| Enumeration Date | 2026-06-01 |
| Last Update Date | 2026-06-01 |