| NPI | 1922265875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105073) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA AP2459) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2009-08-04 |