| NPI | 1659561405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC MPA.5336PA) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: KY PA9111995) |
| 363AS0400X Physician Assistant Surgical (Licence: FL PA9111995) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-07-08 |