| NPI | 1831601517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110882) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA91108822) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2021-05-21 |