| NPI | 1891743357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA23282) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA23282) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA23282) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2016-04-15 |