| NPI | 1558600148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2308) |
| 363A00000X Physician Assistant (Licence: FL PA9107077) | |
| Enumeration Date | 2013-02-03 |
| Last Update Date | 2022-02-17 |