| NPI | 1831549484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109463) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006463) |
| 363A00000X Physician Assistant (Licence: MD C0007139) | |
| 363A00000X Physician Assistant (Licence: CA 60067) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2023-08-07 |