| NPI | 1497552863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD PA200002255) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC 200002255) |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2026-07-15 |