| NPI | 1639328800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104715) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8745) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2022-03-04 |