| NPI | 1639176019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113738) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA001342L) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2022-07-25 |