| NPI | 1881486538 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 7225) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical | 
| Enumeration Date | 2025-05-20 | 
| Last Update Date | 2025-07-29 |