| NPI | 1396832440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 2496) |
| 363A00000X Physician Assistant (Licence: FL PAX00007028) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2013-03-14 |