| NPI | 1407640725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 12984) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: 12984) |
| 363A00000X Physician Assistant (Licence: GA 12984) | |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-28 |