| NPI | 1356011514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115077) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2022-04-04 |