| NPI | 1386605640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03703) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 3651) |
| 363A00000X Physician Assistant (Licence: NM PA-090) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2023-03-07 |