| NPI | 1558895474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00328) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110327) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9110327) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2018-10-10 |