| NPI | 1043228729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-06396) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 001588) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-07-10 |