| NPI | 1720260581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9115370) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA 1076651) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2021-12-23 |