| NPI | 1164119533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104155) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL PA9104155) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2025-09-26 |