| NPI | 1801334362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113106) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 3772) |
| Enumeration Date | 2017-02-05 |
| Last Update Date | 2021-06-08 |