| NPI | 1225804263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 6388) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CT 6388) |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2024-02-05 |