| NPI | 1134516495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108649) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA52411) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2017-11-29 |