| NPI | 1396038444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 9104494) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 2617) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2020-02-25 |