| NPI | 1720455124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3518-23) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 320724) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2024-04-24 |