| NPI | 1265989487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113976) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-50812) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2021-10-29 |