| NPI | 1417994799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001647) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-12-26 |