| NPI | 1023309283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 5851) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2092) |
| 363A00000X Physician Assistant (Licence: GA 005851) | |
| 363A00000X Physician Assistant (Licence: FL PA9109512) | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2024-01-31 |