| NPI | 1114318003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110334) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05695) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2022-07-21 |