| NPI | 1699928556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 1349) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1349) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2021-09-11 |