| NPI | 1942480728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C03706) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 1054970) |
| 363A00000X Physician Assistant (Licence: VA 0110001522) | |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2026-04-10 |