| NPI | 1992715072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9103105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103105) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-12-06 |