| NPI | 1881065845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 5942) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019273) |
| 363A00000X Physician Assistant (Licence: NC 0010-09900) | |
| 363A00000X Physician Assistant (Licence: TN 5942) | |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2025-08-05 |