| NPI | 1699595546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10974) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2025-05-31 |