| NPI | 1255321071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114809) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051596) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-03-25 |