| NPI | 1639468556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107339) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA 9107339) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2024-01-11 |