| NPI | 1144528118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109291) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-2668) |
| 363A00000X Physician Assistant (Licence: NC 0010-02668) | |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2016-11-24 |