| NPI | 1336864156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116392) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9116392) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2025-01-03 |