| NPI | 1104327790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5055-23) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA91100901) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2022-09-14 |