| NPI | 1073847000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3593) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105186) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2020-06-26 |