| NPI | 1033255013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA003199L) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA000458L) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-08 |