| NPI | 1619952934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9103594) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: FL PA9103594) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2022-11-14 |