| NPI | 1861661506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110001235) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2021-08-06 |