| NPI | 1932730439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116052) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL PA9116052) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2023-11-10 |