| NPI | 1407954936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9103875) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103875) |
| 363A00000X Physician Assistant (Licence: PA9103875) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-06-16 |