| NPI | 1154942472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PAT9116032) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: FL CNA352961) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2022-06-30 |