| NPI | 1003925967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 5715) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103077) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-09-22 |