| NPI | 1710531231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112276) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2022-12-20 |