| NPI | 1053342261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: SC 4564) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9103449) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-07-08 |