| NPI | 1467721399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1613) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2024-01-05 |