| NPI | 1518351105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05609) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-08-20 |