| NPI | 1407108558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4631) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60363705) |
| 363A00000X Physician Assistant (Licence: FL PA9106924) | |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2020-05-07 |