| NPI | 1962047670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112758) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: FL 9112758) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2025-01-12 |