| NPI | 1770154098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062641) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA100430) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2025-03-03 |