| NPI | 1063738557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105335) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105335) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2024-05-17 |