| NPI | 1790724144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106092) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01449) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-10-21 |