| NPI | 1720822679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9118794) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9118794) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-11-19 |