| NPI | 1336477579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9105200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105200) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2018-07-02 |