| NPI | 1487727285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105570) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000259A) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-05-18 |