| NPI | 1346677069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 5496) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 5496) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2023-08-24 |