| NPI | 1063190551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9117455) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 9117455) |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-08-31 |