| NPI | 1881148419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109769) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2020-05-12 |