| NPI | 1538307509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PAT9104890) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 002372) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2018-03-28 |