| NPI | 1407816234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112255) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL APRN9112255) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL APRN9112255) | |
| 363AM0700X Physician Assistant Medical (Licence: NC 103487) | |
| 363AM0700X Physician Assistant Medical (Licence: FL 9112255) | |
| 363AS0400X Physician Assistant Surgical (Licence: NC 103487) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-08-11 |