| NPI | 1063715092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109393) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054766) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2023-10-13 |