| NPI | 1942273594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003645) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106613) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-07-25 |