| NPI | 1639479264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA2671) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 4724) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2024-09-17 |