| NPI | 1396851788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1548) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9101771) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-04-27 |