| NPI | 1063477453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0635) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102768) |
| 363A00000X Physician Assistant (Licence: MA 1408) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-01-20 |