| NPI | 1336108141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: GA 004463) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 363AS0400X Physician Assistant Surgical (Licence: FL PA9111128) | |
| 363AS0400X Physician Assistant Surgical (Licence: ID PA-1741) | |
| 363AS0400X Physician Assistant Surgical (Licence: TX PA13075) | |
| 363AS0400X Physician Assistant Surgical (Licence: VA 0110007257) | |
| 363AS0400X Physician Assistant Surgical (Licence: TN PA0000004410) | |
| 363AS0400X Physician Assistant Surgical (Licence: NC 0010-10111) | |
| 363AS0400X Physician Assistant Surgical (Licence: SC PA1200) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-06-03 |