| NPI | 1902038144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2016044080) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2024-01-30 |