| NPI | 1649354812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109519) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052770) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-09-11 |