| NPI | 1467937516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111577) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2022-09-01 |