| NPI | 1194153346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113465) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 007504) |
| 363A00000X Physician Assistant (Licence: NY 017149) | |
| 363A00000X Physician Assistant (Licence: AZ 7518) | |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2023-12-27 |