| NPI | 1114379732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111223) |
| 363A00000X Physician Assistant (Licence: IN 10002724A) | |
| 363A00000X Physician Assistant (Licence: IL 085005839) | |
| 363A00000X Physician Assistant (Licence: TX PA12878) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2022-01-20 |