| NPI | 1285805499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03567) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104473) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2016-07-22 |