| NPI | 1053090191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AL PA.2463) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 12603) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2024-10-17 |