| NPI | 1972043875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116621) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12355) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2024-06-21 |