| NPI | 1700067469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108838) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051269) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2015-12-28 |