| NPI | 1649814997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112671) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13487) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2023-10-02 |