| NPI | 1295208940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111916) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111916) |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2022-11-04 |