| NPI | 1437522638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109488) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C06005) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2016-09-03 |