| NPI | 1225197668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105013) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03122) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-05-14 |