| NPI | 1326472416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PAT9107372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL PA9107372) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2015-03-03 |