| NPI | 1417196411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2277) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 2277) |
| 363A00000X Physician Assistant (Licence: VA 0110002959) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0004225) | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2025-11-18 |