| NPI | 1982248126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110-007882) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2023-09-26 |