| NPI | 1598750374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106446) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000571) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2023-04-27 |