| NPI | 1023320884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113508) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 363A00000X Physician Assistant (Licence: GA 008747) | |
| 363A00000X Physician Assistant (Licence: 2828) | |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2021-02-22 |