| NPI | 1982085551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005999) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108552) |
| 208800000X Urology (Licence: VA 0110005999) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2024-02-16 |