| NPI | 1578193561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 4293) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 4293) |
| Enumeration Date | 2020-01-19 |
| Last Update Date | 2024-05-22 |