| NPI | 1952812273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110835) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 9110835) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2022-04-14 |