| NPI | 1942429204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01267) |
| 363A00000X Physician Assistant (Licence: FL PA 9103555) | |
| 363A00000X Physician Assistant (Licence: VA 0110006167) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-05-12 |