| NPI | 1326006214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00629) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA 3510) |
| 363AS0400X Physician Assistant Surgical (Licence: NC 0010-00629) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-02-21 |