| NPI | 1760484174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8472) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109553) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2021-09-24 |