| NPI | 1578572905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA918145) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110001136) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110001136) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-08-15 |