| NPI | 1356136782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NC 0010-15283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-15283) |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-07-09 |