| NPI | 1811977614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105276) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052244) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2011-11-29 |