| NPI | 1285260661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9114894) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9114894) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2022-03-07 |