| NPI | 1497189088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 305875) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9107417) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2022-07-12 |