NPI | 1699301853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA PA62106) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031828) |
Enumeration Date | 2020-03-19 |
Last Update Date | 2025-05-21 |