| NPI | 1043728470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 00010-09072) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111041) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2019-10-27 |