| NPI | 1124757513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116245) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL 9116245) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-11-09 |