| NPI | 1760421960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2746) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102503) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-01-08 |