| NPI | 1417322181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116426) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116426) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2023-01-12 |