| NPI | 1124772496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115672) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115672) |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2024-09-19 |