| NPI | 1720020605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106001) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002979) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-12-07 |