| NPI | 1487129615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9115314) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA060354) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-02-02 |