| NPI | 1285864967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 472) |
| 363A00000X Physician Assistant (Licence: OH 002915) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2017-01-06 |