| NPI | 1538103304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA-9104037) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 005242) |
| 363A00000X Physician Assistant (Licence: FL PA9104037) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-07-16 |