| NPI | 1124260930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115887) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002222) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2022-04-25 |