| NPI | 1891737177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9102451) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 20838) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-06-04 |