| NPI | 1609958883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105962) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 00000PA16743) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-07-02 |