| NPI | 1306182555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106875) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAX00009762) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9106875) | |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2013-04-04 |