| NPI | 1255880696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 9109893) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9109893) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2024-04-26 |