| NPI | 1265459010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 004842) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9104234) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-07-23 |