| NPI | 1053615237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA 9105638) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105638) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2022-02-18 |