| NPI | 1285218230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NE 2964) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113963) |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2025-01-23 |