| NPI | 1700028602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3760) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2026-04-21 |