| NPI | 1124351572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9106114) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9106114) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2017-02-07 |