| NPI | 1306242748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9108141) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108141) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2017-10-13 |