| NPI | 1801361654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111690) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9111690) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |