| NPI | 1073703849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00931) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2014-08-05 |