| NPI | 1376732511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104382) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004117) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2015-11-12 |