| NPI | 1477364685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 2522) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL 2522) |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-16 |