| NPI | 1336104322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110738) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 18243) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-01-03 |