| NPI | 1679618318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111285) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 000835) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-10-23 |