| NPI | 1144502154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9695) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106122) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2024-05-17 |