NPI | 1194503722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 12976) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-09-15 |
Last Update Date | 2025-04-28 |