| NPI | 1881200202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: NC 0010-14046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-14046) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2024-04-18 |