| NPI | 1972030765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117136) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9117136) |
| 363AM0700X Physician Assistant, Medical (Licence: AK 139211) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-07-27 |