| NPI | 1326352634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-2432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105513) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2012-07-12 |