| NPI | 1154558203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111824) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053839) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2019-04-09 |