| NPI | 1699788968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103777) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PAT9103777) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-03-24 |