| NPI | 1760410880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NE 371) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 371) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-10-30 |