| NPI | 1215245006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105614) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8516) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2023-02-22 |