| NPI | 1720389570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105612) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PAT9105612) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2023-04-10 |