| NPI | 1316282247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110368) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND 6059) |
| 363A00000X Physician Assistant (Licence: FL PA9110368) | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2022-07-21 |