| NPI | 1609563378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 22-498) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 003056P) |
| 363A00000X Physician Assistant (Licence: FL TPPA1231) | |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2026-06-04 |