| NPI | 1740279587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA2362) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA2362) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2018-02-28 |