| NPI | 1841387735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA9106347) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 102514) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-04-04 |