| NPI | 1023999174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: FL 25-297) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 2759-P.A.) |
| 363AS0400X Physician Assistant, Surgical (Licence: PR 2759-P.A.) | |
| 363A00000X Physician Assistant (Licence: PR 2759-P.A.) | |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-11-13 |