| NPI | 1487843595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9104304) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-003587) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: MD C0004536) | |
| 363A00000X Physician Assistant (Licence: TX PA06931) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2020-09-11 |