| NPI | 1306512066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9117002) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10460) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2023-08-04 |