| NPI | 1528634045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114469) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAX000018146) |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-07-15 |