| NPI | 1982993143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105761) |
| Additional Taxonomies | 281P00000X Chronic Disease Hospital (Licence: FL PAX00008518) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2020-05-26 |