| NPI | 1891301263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113595) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL PAT9113595) |
| 208600000X Surgery (Licence: FL PA9113595) | |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2022-09-27 |