| NPI | 1497059273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114297) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114297) |
| 363A00000X Physician Assistant (Licence: CA 54208) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2022-04-07 |