| NPI | 1013505940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4964) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: FL PA9113743) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9113743) | |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2024-07-17 |