| NPI | 1093045569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105931) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical (Licence: FL 9105931) | |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2024-08-12 |