| NPI | 1932536489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005768) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107553) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-06-21 |