| NPI | 1205943099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9102138) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052242) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-10-17 |