| NPI | 1598258212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117606) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9117606) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-10-04 |