| NPI | 1669874905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL PA9108619) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108619) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 007282) | |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2021-05-14 |