| NPI | 1275974081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106935) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002388) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2014-06-20 |