| NPI | 1023225224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113392) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000091) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-12-24 |