| NPI | 1114939048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004572) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2010-01-13 |