| NPI | 1982084950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108740) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA 60919) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2024-07-21 |