| NPI | 1184909905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 53883) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106201) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106201) | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2018-11-12 |