| NPI | 1215174057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108664) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05965) |
| 363A00000X Physician Assistant (Licence: NY 016283) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2017-05-01 |