| NPI | 1346642311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113940) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06485) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2021-04-06 |