| NPI | 1184945636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3106) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9105126) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2021-12-16 |