| NPI | 1992094999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110057) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01538) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2023-11-01 |