| NPI | 1003874074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 001720) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 001720) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2016-06-07 |