| NPI | 1154034452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: GA 207688) |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-11-09 |