| NPI | 1770579864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 5000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL aa-824) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2026-03-09 |