| NPI | 1720336712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110517) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2173) |
| Enumeration Date | 2012-08-22 |
| Last Update Date | 2022-01-07 |