| NPI | 1295877785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108416) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 1338) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-03-28 |