| NPI | 1376710541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9115617) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: GA 5317) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2023-10-31 |