| NPI | 1871038513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9109968) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109968) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2021-06-20 |