| NPI | 1487209342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112065) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 1160980) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2024-12-21 |