| NPI | 1598196974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 100961-875) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5596) |
| 363A00000X Physician Assistant (Licence: CO PA.0003941) | |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 5596) | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2025-04-15 |