| NPI | 1558125401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PR 328PA) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 328PA) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |