| NPI | 1275027435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112970) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-09-19 |