| NPI | 1295373710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116932) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2023-02-21 |