| NPI | 1760575013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108653) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011398) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2025-07-14 |