| NPI | 1083127922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA11009330) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2721) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2021-04-29 |