| NPI | 1477118149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C07260) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2022-06-07 |