| NPI | 1992777973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105804) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 002304) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-12-23 |