| NPI | 1225915515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: DE C5-0012317) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0012317) |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-09-26 |