| NPI | 1881220275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2020010084) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9112867) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-11531) | |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2023-05-01 |