| NPI | 1003481680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114380) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9114380) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-07-19 |