| NPI | 1780997734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108862) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054374) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2021-02-25 |