| NPI | 1326475799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51438) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5644) |
| 363A00000X Physician Assistant (Licence: FL PA9107142) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9107412) | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2020-08-07 |