| NPI | 1295882405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104165) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: SC A524-IM) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2010-02-16 |