| NPI | 1386994531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107662) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03782) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2023-01-11 |