| NPI | 1669626461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004184) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2024-08-19 |