| NPI | 1821197930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA2819) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-04-25 |