| NPI | 1821531070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111251) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 23.003728) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9111251) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2024-07-17 |