| NPI | 1285060566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111177) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-006162) |
| 363A00000X Physician Assistant (Licence: NE 2229) | |
| 363A00000X Physician Assistant (Licence: TX PA11020) | |
| 363A00000X Physician Assistant (Licence: NY 016971-1) | |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2021-09-15 |