| NPI | 1689868275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104312) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005037) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2015-02-03 |