| NPI | 1043753643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115409) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 085084) |
| 363A00000X Physician Assistant (Licence: CA PA54855) | |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2023-01-25 |