| NPI | 1659151520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KY TC023) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA200002085) |
| 363A00000X Physician Assistant (Licence: FL 9117802) | |
| 363A00000X Physician Assistant (Licence: VA 0110009703) | |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2026-05-28 |