| NPI | 1992271233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111501) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9111501) |
| Enumeration Date | 2018-10-14 |
| Last Update Date | 2021-12-01 |