| NPI | 1386174613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9645) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110413) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2023-03-21 |