| NPI | 1679098305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100657) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2024-07-15 |