| NPI | 1306817598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106519) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA820) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2012-07-25 |