| NPI | 1700049764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116349) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MD C0003783) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-01-11 |