| NPI | 1376510982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 3452) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC PA2352) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113053) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-05-12 |