| NPI | 1992547830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118777) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MA065543) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2025-10-28 |