| NPI | 1154374460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA3274) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA3274) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-09-04 |