| NPI | 1225496896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06276) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-06276) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-02-18 |