| NPI | 1982644308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105711) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 000452) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-08-26 |