| NPI | 1588108419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109938) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2021-07-30 |