| NPI | 1518045509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL pa9102898) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102898) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-09-04 |