| NPI | 1699702944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103210) |
| 363A00000X Physician Assistant (Licence: WA PA60948597) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103210) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-11-13 |