| NPI | 1366034761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113960) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113960) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-09 |