| NPI | 1669450144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1536) |
| 363A00000X Physician Assistant (Licence: TX PA16652) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MA 1536) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2023-12-02 |