| NPI | 1063434009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61138370) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3197) |
| 363A00000X Physician Assistant (Licence: FL PA9110554) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-06-09 |