| NPI | 1861554677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9107340) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9107340) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2016-11-30 |