| NPI | 1235485319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106495-PAX9356) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2022-07-21 |