| NPI | 1508414657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7569) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 7569) |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2023-06-05 |