| NPI | 1033192349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA pa21515) |
| 363A00000X Physician Assistant (Licence: NM PA2009-0035) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2024-05-16 |