| NPI | 1720211451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4837) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 1761) |
| 363A00000X Physician Assistant (Licence: FL PA9110282) | |
| 363A00000X Physician Assistant (Licence: NH 1544) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2024-05-31 |