| NPI | 1093888224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115907) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 232558) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA04975) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-05-16 |