| NPI | 1811969280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9263) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102676) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-07-26 |