| NPI | 1609489541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9112708) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL PA9112708) |
| 363LA2100X Nurse Practitioner Acute Care (Licence: FL PA9112708) | |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-08-29 |