| NPI | 1396134961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109027) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2016-12-14 |