| NPI | 1023267952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003041) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053558) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2016-04-26 |