| NPI | 1164662334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105369) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002956) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2011-02-23 |