| NPI | 1811520083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9112826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112826) |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2023-04-06 |