| NPI | 1871975995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 001006339) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109738) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2022-04-21 |