| NPI | 1700482361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062034) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2023-08-24 |