| NPI | 1871062869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115766) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 310589) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2022-03-11 |