| NPI | 1073697595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0836) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2022-09-01 |