| NPI | 1013241454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NE 1725) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054128) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2013-05-29 |