| NPI | 1528436649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108925) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9108925) |
| Enumeration Date | 2015-09-05 |
| Last Update Date | 2023-10-19 |