| NPI | 1518244326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113210) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015249) |
| 363A00000X Physician Assistant (Licence: FL PA113210) | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2023-04-12 |