| NPI | 1932421989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105305) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105305) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2022-08-15 |