| NPI | 1932252442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: FL PA9102448) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2013-02-14 |