| NPI | 1083626436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002613) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9103032) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-08-10 |