| NPI | 1992907273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104709) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001796) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2015-03-06 |