| NPI | 1033952627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: DC PA200001981) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-08-31 |