| NPI | 1184712960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA1621) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA0001621) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-01-04 |