| NPI | 1093754582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110226) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA002059L) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-06-02 |