| NPI | 1861666398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106883) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01319) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-02-12 |