| NPI | 1356302111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00632) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 1313) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-06-04 |