| NPI | 1376980045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2025041627) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 2353) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2025-10-22 |