| NPI | 1497968473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA1700) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-02-18 |