| NPI | 1356608491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106505) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9106505) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2024-03-20 |