| NPI | 1255675187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9118855) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 3588) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO 0003588) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2024-08-20 |