| NPI | 1306170352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114387) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0005924) |
| 363A00000X Physician Assistant (Licence: MN 2178) | |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2023-08-21 |