| NPI | 1295350411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113383) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL PA9113383) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2026-04-20 |