| NPI | 1386741536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108683) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-10-23 |