| NPI | 1366873796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116523) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06920) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2024-07-12 |