| NPI | 1356303200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113175) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01649) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01649) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-06-01 |