| NPI | 1295940914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113304) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.493) |
| 363AS0400X Physician Assistant, Surgical (Licence: AL PA-493) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-05-17 |