| NPI | 1144730664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113847) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54986) |
| 363A00000X Physician Assistant (Licence: WV 775) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2021-11-23 |