| NPI | 1083715668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 004852) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1551) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-10-31 |