| NPI | 1396917522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9101648) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9101648) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2024-01-17 |