| NPI | 1356824403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117740) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08430) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2024-02-06 |