| NPI | 1265611966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118914) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001863) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2024-10-24 |