| NPI | 1679193676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9114293) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 60850) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-05-18 |