| NPI | 1417401076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9109688) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109688) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2025-05-20 |