| NPI | 1194033860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9105647) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2025-01-21 |