| NPI | 1356659437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105623) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA1095039) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2011-09-12 |