| NPI | 1972844660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108054) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 003708) |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108054) | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2022-09-20 |