| NPI | 1366904138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9113551) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-02-06 |