| NPI | 1730583436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 2184) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109424) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2023-03-20 |