| NPI | 1639850126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8430) |
| Additional Taxonomies | 208800000X Urology (Licence: PA MA064690) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2025-09-15 |