| NPI | 1376566182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-410) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102973) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-12 |