| NPI | 1386355394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9968) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 9968) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2025-02-17 |