| NPI | 1568187920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116531) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: FL PA9116531.) |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2023-07-14 |