| NPI | 1366611899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9111848) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19388) |
| 363AM0700X Physician Assistant Medical (Licence: AZ 4391) | |
| 363AM0700X Physician Assistant Medical (Licence: FL PA9107135) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2023-03-07 |