| NPI | 1487057899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108239) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4044) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9108239) | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2023-10-19 |