| NPI | 1588699672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA3128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004469) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-03-03 |