| NPI | 1316685357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 22-129) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 22-129) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2024-01-15 |