| NPI | 1073833463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004172) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108689) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2015-11-09 |