| NPI | 1336860998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-16475) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9118129) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2026-06-16 |