| NPI | 1891209870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA185615) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2023-10-02 |