| NPI | 1376685651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 004598) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9104004) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-01-13 |