| NPI | 1073524864 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103579) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9103579) | 
| Enumeration Date | 2006-08-10 | 
| Last Update Date | 2019-02-07 |