| NPI | 1033774864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112313) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112313) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2023-03-15 |