| NPI | 1851941983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112557) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112557) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2026-07-31 |