| NPI | 1376179267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112489) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA9112489) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2023-02-07 |