| NPI | 1134768237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112832) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9112832) |
| 363A00000X Physician Assistant (Licence: CA 57446) | |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2023-09-13 |