| NPI | 1194020529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN tn2516) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105864) |
| 363A00000X Physician Assistant (Licence: FL PAT9105864) | |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2016-06-11 |