| NPI | 1033251186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01761) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9103738) |
| 363AM0700X Physician Assistant, Medical (Licence: MA 2378) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-04-24 |