| NPI | 1689780959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9103694) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA 051508) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-05-07 |