| NPI | 1992923957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030464) |
| 363A00000X Physician Assistant (Licence: VA 0110002415) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-11-19 |