| NPI | 1770927501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113833) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008028) |
| 363A00000X Physician Assistant (Licence: PA MA056085) | |
| 363A00000X Physician Assistant (Licence: WI 7235) | |
| 363A00000X Physician Assistant (Licence: GA 9523) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2024-06-28 |