| NPI | 1821300849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114533) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005862) |
| 363A00000X Physician Assistant (Licence: KY PA2985) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2022-10-20 |