| NPI | 1477884203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111476) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003213) |
| 363A00000X Physician Assistant (Licence: MD C0004164) | |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2018-10-18 |