| NPI | 1902262595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110009745) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2025-09-12 |