| NPI | 1265711501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107323) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7355) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-03-19 |