| NPI | 1790458552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114459) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2021-09-16 |