| NPI | 1043321573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 760) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-11-09 |