| 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 |