| NPI | 1285931113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105898) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2050) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2018-11-07 |