| NPI | 1205071107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103503) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9103503) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2022-11-16 |