| NPI | 1841714334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 54638) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2021-03-18 |