| NPI | 1841184751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA 347904) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA 347904) |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2026-01-06 |