| NPI | 1215260500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21000) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2017-04-18 |