| NPI | 1811921372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA 9106151) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL SW 6735) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-08-15 |