| NPI | 1326521063 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 11266) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical | 
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-09-10 | 
| Last Update Date | 2025-10-15 |