| NPI | 1861687386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22027) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2022-08-15 |