| NPI | 1659969772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116632) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116632) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2022-12-08 |