| NPI | 1285797258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103793) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-11-12 |