| NPI | 1427236652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104340) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 2357) |
| 363A00000X Physician Assistant (Licence: FL PA9104340) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2020-10-12 |