| NPI | 1831600501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL pa9110755) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2019-04-16 |