| NPI | 1982087516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC 207P00000X) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2020-08-28 |