| NPI | 1689915167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107807) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1104320) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2024-02-14 |