| NPI | 1033738349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 9758) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2023-08-23 |