| NPI | 1558346213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102817) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA-377) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2013-06-12 |