| NPI | 1023112653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 2563) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA0002563) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2010-05-05 |