| NPI | 1225512072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9111496) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2023-05-23 |