| NPI | 1245279140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110244) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004614) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110244) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-03-29 |