| NPI | 1275913907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057603) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003849) |
| 363A00000X Physician Assistant (Licence: FL PA9115737) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2025-01-29 |