| NPI | 1619531977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL R9371494) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: FL R9371494) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |