| NPI | 1558394304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106472) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106472) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-09-15 |