| NPI | 1669920336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109758) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2021-01-11 |