| NPI | 1982971305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: AZ 130372) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2024-09-20 |