| NPI | 1326444712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111226) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005605) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2018-10-02 |