| NPI | 1477104883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 10284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10284) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2026-06-29 |