| NPI | 1467512640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9102367) |
| Additional Taxonomies | 208800000X Urology (Licence: FL PA 9102367) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA 9102367) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-03-22 |