| NPI | 1780824136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111842) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA.910) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2022-08-02 |