| NPI | 1619944154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00359) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2023-09-28 |