| NPI | 1013190438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002053) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9105078) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2018-10-17 |