| NPI | 1649863978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117213) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007815) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2024-03-09 |