| NPI | 1407651508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0010050) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 23.007227) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9120552) | |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-09-26 |