| NPI | 1821614991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115050) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-10292) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2022-01-05 |