| NPI | 1336271451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9101096) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL PA9101096) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2019-05-24 |