| NPI | 1689358509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA200002242) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2026-0039) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2026-05-21 |