| NPI | 1275901142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108959) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9108959) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2019-05-10 |