| NPI | 1336597137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9109547) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9109547) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2023-10-26 |