| NPI | 1417930124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3307) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 103517) |
| 363A00000X Physician Assistant (Licence: NC 103517) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2026-05-15 |