| 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 |