| NPI | 1912367178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06671) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109225) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-12-21 |