| NPI | 1407186398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104704) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL PA 9104704) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9104704) | |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2024-04-03 |