| NPI | 1326065400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9108059) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052548) |
| 363AM0700X Physician Assistant Medical (Licence: PA MA052548) | |
| 363A00000X Physician Assistant (Licence: RI PA00418) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2015-05-28 |