| NPI | 1811444250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 66197) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 019655) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2025-04-03 |