| NPI | 1598003899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107820) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA-877) |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2020-01-06 |