| NPI | 1538412408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 009099) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106830) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2019-02-12 |