| NPI | 1285276139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117342) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061187) |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2024-02-02 |