| NPI | 1396061123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105244) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2967) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2020-11-22 |