| NPI | 1366483448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103108) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC PAX00005900) |
| 363AM0700X Physician Assistant, Medical (Licence: VI 76) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-01-23 |