| NPI | 1407570955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA OA006227) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA063906) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2025-02-26 |