| NPI | 1134858244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PT9115969) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL PA9115969) |
| 363A00000X Physician Assistant (Licence: FL PA9115969) | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-07-05 |