| NPI | 1578905576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05008) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005756) |
| 363A00000X Physician Assistant (Licence: FL PA9107279) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2022-05-17 |