| NPI | 1184821464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 12889) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 12889) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2024-11-22 |