| NPI | 1598017758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106756) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2018-01-28 |