| NPI | 1952606444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105889) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2024-04-24 |