| NPI | 1851795066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9113728) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-658) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2021-01-08 |