| NPI | 1689843054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA-9107363) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002724) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110002724) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2016-02-02 |