| NPI | 1366986861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110871) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2563) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 8238) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9112017) | |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2024-09-26 |