| NPI | 1548651847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113345) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA058435) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2022-03-21 |