| NPI | 1518543826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116317) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10219) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2022-12-08 |