| NPI | 1306376009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2017025357) |
| 363A00000X Physician Assistant (Licence: MO 2017025357) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2025-11-04 |