| NPI | 1659986677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118672) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: WI 5266) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2024-08-28 |