| NPI | 1235545567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108016) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058177) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2017-01-11 |