| NPI | 1740554500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106605) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055440) |
| Enumeration Date | 2012-02-26 |
| Last Update Date | 2013-07-18 |