| NPI | 1013185479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA1350) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104526) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2023-01-06 |