| NPI | 1609185651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106016) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9106016) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2019-02-08 |