| NPI | 1619087095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3626) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 003197) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-09-12 |