| NPI | 1922286681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106596) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01230) |
| 363AM0700X Physician Assistant, Medical (Licence: SC PA-1471) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2023-01-11 |