| NPI | 1568700490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107492) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 2445) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2020-02-21 |