| NPI | 1891985669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105970) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001762) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2023-10-30 |