| NPI | 1134227754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA91041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 560) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-21 |