| NPI | 1962546408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104556) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9104556) |
| 363A00000X Physician Assistant (Licence: GA 004981) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2019-11-20 |