| NPI | 1871575324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS PA064) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL pa9103034) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2011-03-21 |