| NPI | 1457755969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107531) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 030679) |
| 363A00000X Physician Assistant (Licence: CT 6456) | |
| 363A00000X Physician Assistant (Licence: AZ 9642) | |
| 363A00000X Physician Assistant (Licence: GA 11584) | |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2024-02-07 |