| NPI | 1124376355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3979) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106821) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2021-10-14 |