| NPI | 1790095479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08626) |
| 363A00000X Physician Assistant (Licence: AL PA968) | |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2018-04-03 |