| NPI | 1407007206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 63491) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 63491) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2025-06-19 |