| NPI | 1134599541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109051) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 3730) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2023-07-10 |