| NPI | 1518736180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010309) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VA 0110010309) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: VA 0110010309) | |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2025-02-12 |