| NPI | 1447603774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001007717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109665
) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2021-03-25 |