| NPI | 1538561576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9110700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001005233) |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical (Licence: TN 2933) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TN 2933) | |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2022-07-22 |