| NPI | 1194091439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9013676) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07985) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2013-08-08 |