| NPI | 1457421182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119134) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CO 1839) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-09-04 |