| NPI | 1326070533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9100922) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9100922) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2017-08-10 |