| NPI | 1336151687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9101441) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-03-25 |