| NPI | 1740361997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9103789) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-12-08 |