| NPI | 1013473008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AR PA-886) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR PA-886) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2022-03-30 |