| NPI | 1467415273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9120344) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 1753-023) |
| 363A00000X Physician Assistant (Licence: WI 1753-23) | |
| 363A00000X Physician Assistant (Licence: CO 4056) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2025-11-05 |