| NPI | 1669873352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110867) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60931998) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110867) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60931998) | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-06-23 |