| NPI | 1639506199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107527) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005142) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-11-22 |