| NPI | 1659385169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11040) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111216) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2022-11-02 |