| NPI | 1285932152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3766) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110624) |
| 363A00000X Physician Assistant (Licence: NC 0010-02758) | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2020-08-31 |