| NPI | 1093254401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114656) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1265) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2023-03-29 |