| NPI | 1831361401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108037) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2246-23) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2015-09-22 |