| NPI | 1417328253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109119) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 5150) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2019-12-16 |