| NPI | 1336415256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9106585) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03437) |
| 363A00000X Physician Assistant (Licence: SC 5416) | |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2024-10-10 |