| NPI | 1518408384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7574) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181971) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 7574) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2026-05-15 |