| NPI | 1053445866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00285) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005537) |
| 363A00000X Physician Assistant (Licence: AZ 5752) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2014-11-26 |