| NPI | 1134643281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9112422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6208) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2021-12-17 |