| NPI | 1073523726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106884) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110002115) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-27 |