| NPI | 1295764959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000001232) |
| 363A00000X Physician Assistant (Licence: GA 004942) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-04-16 |