| NPI | 1851994131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA061951) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MA061951) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2022-03-02 |