| NPI | 1033675467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115651) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9141) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2022-04-26 |