| NPI | 1023091717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 2405) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA2405) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2013-12-31 |