| NPI | 1598741316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1223) |
| 363AM0700X Physician Assistant Medical (Licence: FL PA9103581) | |
| 363AM0700X Physician Assistant Medical (Licence: AZ 3352) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2023-01-12 |