| NPI | 1023288917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113919) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-936) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA-2744) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2023-03-27 |