| NPI | 1336320837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 152085) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA3646) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2022-11-16 |