| NPI | 1396020426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3386) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106248) |
| 363A00000X Physician Assistant (Licence: FL PA9106248) | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2026-01-21 |