| NPI | 1033528120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA 9108681) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 074796) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2016-04-25 |