| NPI | 1801435714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA OA005168) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061365) |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2023-09-27 |