| NPI | 1710057344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102115) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-11-15 |