| NPI | 1740887108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 4296) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2025-02-11 |