| NPI | 1447665377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0110004618) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2021-01-26 |