| NPI | 1285882571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104626) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2019-09-12 |