| NPI | 1992406698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-2569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2569) |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-09-25 |