| NPI | 1841574050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06837) |
| 363A00000X Physician Assistant (Licence: NY 014849) | |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2015-04-03 |