| NPI | 1407219801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA066102) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1725) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2025-06-23 |