| NPI | 1275044968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110748) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059523) |
| 363A00000X Physician Assistant (Licence: PA OA004343) | |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2017-12-15 |