| NPI | 1548443518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109183) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1501298) |
| 363A00000X Physician Assistant (Licence: NY 012303) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2018-12-18 |