| NPI | 1306603824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118268) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL PA9118268) |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-04-19 |