| NPI | 1083895775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106589) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 001941) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2024-01-16 |