| NPI | 1881017580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004501) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: VA 0110004501) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2025-05-15 |