| NPI | 1083953475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117669) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA64943) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2025-01-27 |