| NPI | 1477830909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109608) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 006840) |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2023-02-24 |