| NPI | 1063541217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002102) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 724) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2012-09-21 |