| NPI | 1942948914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4765) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2025-02-11 |