| NPI | 1568930949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5083) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 5083-23) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2025-09-19 |