| NPI | 1306779590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL TPPA1135) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 2755-P.A.) |
| 363AM0700X Physician Assistant, Medical (Licence: PR 2755-P.A.) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 24-537) | |
| 363AS0400X Physician Assistant, Surgical (Licence: PR 2755-P.A.) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO S.A.0003415) | |
| Enumeration Date | 2026-06-05 |
| Last Update Date | 2026-06-05 |