| NPI | 1821244302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA627) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2017-04-12 |