| NPI | 1942217195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103764) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103764) |
| 363A00000X Physician Assistant (Licence: FL PAT9103764) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-05-29 |