| NPI | 1780166330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111540) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: FL PA9111540) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2020-03-12 |