| NPI | 1982112926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14293) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110805) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2024-07-23 |