| NPI | 1902824139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112835) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9112835) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 03102) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2022-05-24 |