| NPI | 1578869558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C06807) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105878) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105878) | |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2024-02-23 |