| NPI | 1215309919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9116789) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 6207) |
| 363AM0700X Physician Assistant Medical (Licence: CA PA63330) | |
| 363AM0700X Physician Assistant Medical (Licence: ID PACA-3534) | |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2024-06-11 |