| NPI | 1225671597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9118707) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9118707) |
| 363A00000X Physician Assistant (Licence: NC 0010-09439) | |
| Enumeration Date | 2019-10-19 |
| Last Update Date | 2024-04-28 |