| NPI | 1003405705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 21-297) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2021-01-16 |
| Last Update Date | 2023-02-06 |