| NPI | 1861573073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107855) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA994) |
| 363A00000X Physician Assistant (Licence: NC 0010-01293) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2014-06-25 |