| NPI | 1801637830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 127826) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0009233) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-09-10 |