| NPI | 1982018024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05294) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2020-05-05 |