| NPI | 1811193998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003212) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102712) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2019-05-03 |