| NPI | 1417506791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9112531) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-10377) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2022-11-29 |