| NPI | 1235403312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106411) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9106411) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2023-12-18 |