| NPI | 1922643139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118887) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001357) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2024-10-14 |