| NPI | 1770248668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9115246) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2025-03-10 |