| NPI | 1528583762 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 6878)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6878)  | 
| Enumeration Date | 2017-08-09 | 
| Last Update Date | 2024-12-13 |