| NPI | 1073895132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107904) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 000000000) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2020-06-10 |