| NPI | 1689121246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109945) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 083667) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2019-11-06 |