| NPI | 1679544886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01030) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102334) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2009-12-29 |