| NPI | 1760834691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011160) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007357) |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2026-06-30 |