| NPI | 1427096882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA 9102778) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 000793) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-03-19 |