| NPI | 1063694875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0219) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23012294) |
| 363A00000X Physician Assistant (Licence: NV PA1228) | |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2011-08-15 |