| NPI | 1366984080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111114) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5982) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2022-09-26 |