| NPI | 1588218739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117317) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060583) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2024-11-04 |