| NPI | 1356800353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9115685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115685) |
| 363A00000X Physician Assistant (Licence: MD C07144) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-06-12 |