| NPI | 1174779821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114447) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051148) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2022-03-29 |