| NPI | 1588903108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL 9107042) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL 9107042) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2021-03-12 |