| NPI | 1598300238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9112786) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112786) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-06-28 |