| NPI | 1063882975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 52901) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109202) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9109202) | |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2023-03-14 |