| NPI | 1952027716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 213290) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-25 |