| NPI | 1700022613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106967) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005491) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2013-04-10 |