| NPI | 1396237566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116173) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-08147) |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2022-08-30 |