| NPI | 1285980136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12977) |
| 363A00000X Physician Assistant (Licence: PA MA061623) | |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-05-24 |