| NPI | 1972082899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4459-23) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 4459-23) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2025-12-17 |