| NPI | 1558647610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 9106225) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2019-04-23 |