| NPI | 1689921116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106624) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA9106624) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2013-04-19 |