| NPI | 1982799722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104189) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00525) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2011-11-28 |