| NPI | 1033406749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106715) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 5980) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2023-01-05 |