| NPI | 1477862472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07756) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105659) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105659) | |
| Enumeration Date | 2010-09-26 |
| Last Update Date | 2022-01-04 |