| NPI | 1992356307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12365) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114183) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2022-10-19 |