| NPI | 1609051192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 11484) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 910903) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2016-05-19 |