| NPI | 1104268184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107298) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9107298) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2022-12-27 |