| NPI | 1023650520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 004645) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA PA7246) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2020-06-19 |