| NPI | 1023260783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA778) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-778) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2012-04-23 |