| NPI | 1972732261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115233) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003978) |
| 363AM0700X Physician Assistant, Medical (Licence: DC PA031233) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2022-07-30 |