| NPI | 1679083919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110648) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110648) |
| Enumeration Date | 2017-09-30 |
| Last Update Date | 2018-03-27 |