| NPI | 1265823785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA057420) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: FL 9111846) | |
| 363A00000X Physician Assistant (Licence: PA MA057420) | |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2024-11-04 |